系统性红斑狼疮患者血清卵泡抑素样蛋白1表达水平及其临床意义

目的 检测系统性红斑狼疮(SLE)患者血清中卵泡抑素样蛋白1(FSTL1)的水平及FSTL1在狼疮肾炎肾脏组织中的表达,探讨其在SLE疾病中的临床意义.方法 酶联免疫吸附试验(ELISA)法检测54例SLE患者及27名健康对照组血清FSTL1水平.免疫组织化学染色检测狼疮肾炎患者肾脏组织及健康者肾脏组织中FSTL1的表达情况.采用Mann-WhitneyU/检验、t检验、X2检验及Pearson检验进行统计分析.结果 SLE组FSTL1血清水平(26±21) μg/L显著高于健康对照组(12±14) μg/L(P＜0.01)；SLE高血压组明显高于非高血压组(P＜0.01);SLE病程≥5年组与病程＜5年组之间差异有统计学意义(P＜0.01)；血清FSTL1表达水平与SLE疾病活动指数(SLEDAI)评分(r=0.319,P=0.022)、年龄(r=0.700,P＜0.01)、病程(r=0.513,P＜0.01)、补体C4 (r=0.443,P=0.004)、总胆固醇(r=0.460,P=0.001)呈正相关；与血小板计数(r=-0.422,P=0.001)、抗双链DNA(dsDNA)抗体水平(r=--0.276,P=0.046)呈负相关.FSTL1主要表达在肾小管上皮细胞胞质内.结论 FSTL1在SLE患者血清中明显升高,且与疾病活动性有关.提示FSTL1在SLE发病机制中起一定作用.

The expression and clinical significance of serum follistatin-like protein 1 in patients with systemic lupus erythematosus

Objective To detect the serum level of follistatin-like protein 1 (FSTL1) in patients with systemic lupus erythematosus (SLE) and its expression in renal biopsy tissues in lupus nephritis (LN) patients as well as its clinical significance were analyzed.Methods The serum concentration of FSTL1 in 54 SLE patients and 27 healthy controls was measured with enzyme-linked immunosorbent assay (ELISA).The distribution of FSTL1 in renal biopsy tissues was stained by immune-histochemical method.Mann-Whitney U test,t test,X2test and Pearson test were selected to compare the changes and data analysis.Results The serum FSTLI level was significantly higher in SLE patients (26±21) μg/L than those of healthy controls ( 12± 14) μg/L (P＜0.01).The level of serum FSTL1 was significantly higher in SLE patients with hypertension than in patients without hypertension.The serum FSTL1 level had statistically significant changes between SLE patients with disease duration ≥ 5 years and ＜5 years.The level of serum FSTL1 correlated positively with SLEDAI score (r=0.319,P=0.022),age (r=0.700,P＜0.01),disease duration (r=0.513,P＜0.01),complement C4 level (r=0.443,P=0.004),and total serum cholesterol level (r=0.460,P=0.001 ).FSTL1 correlated inversely with platelet count (r=-0.422,P =0.001 ),anti-dsDNA antibody levels (r=-0.276,P=0.046).FSTL1 expression was evident in the cytoplasm of epithelial cells of kidney tubules.Conclusion The level of serum FSTL1 is significantly increased in SLE patients.FSTL1 concentration correlats positively with disease activity.These data indicate that FSTL1 may play a role in the pathogenesis of SLE.